MSK Special Tests

Question 1

Spurlings compression test
(Who/ when not to/ how/ positive)

Answer 1

RADICULOPATHY
Who: Perform in patients with history of reticular pain
Not performed, if there’s any history of trauma
Instructed patient to move neck into hyper extension and lateral flexion towards the side of the symptoms
If AROM doesnt produce pain, examiner applies gentle compressive force
Positive = reproduction of radicular pain

Question 2

Lhermitte Sign (Who/ when not to/ how/ positive)

Answer 2

RADICULOPATHY
Performed on patients with hx of radicular pain (NONE CURRENT)
Patient instructed to flex neck forward, tilting head down
Positive = paresthesia/electric shock, tape pain down the spine

Question 3

Cervical distraction test

Answer 3

RADICULOPATHY
Do on patients with current radicular symptoms
Patient supine on table—> examiner pulls on how patients chin
Positive = reduction, or alleviation of symptoms was traction

Question 4

Shoulder abduction test
(Bakody’s Sign)

(Who/ when not to/ how/ positive)

Answer 4

RADICULOPATHY
Performed on patience with current ridiculous symptoms
Patient places hand on top of the head, examiner determines presence/absence of symptoms
Positive = reduction of pain with maneuver

Question 5

Roo Test (elevated arm stress test)

Answer 5

THORACIC OUTLET SYNDROME
Patient abduction to 90° and externally rotate both arms elbows flexed at 90° patient open and close his hand for three minutes (field goal arms/open close hands)
Positive= and ability to hold arms up without experiencing pain or heaviness

Question 6

Adson test

Answer 6

TOS
Examiner, Abducts, extends, and externally rotate patient’s arm and has patient take a deep breath and turned head towards are being tested
Positive = diminished or absent radial pulse with maneuver

Question 7

Step deformity

Answer 7

AC JOINT PATHOLOGY
Observation and palpation only

Patient seated with involved arm at their side . Examiner stand in front of patient and observed/palpates AC joint

Positive = obvious deformity of AC joint and pain on how patient

Question 8

Crossarm adduction

Answer 8

AC JOINT PATHOLOGY
Examiners extends, and possibly adducts patients affected arm across patience, body

Positive = pain over AC joint with maneuver

Suggestive of joint sprain, or OA

Question 9

Sulcus sign

Answer 9

LABRAL DISORDER/ LIGAMENT LAXITY/ MUSCLE TEAR

Examiner stands behind patient in grasp, lower humerus and proximal forearm and pulls down, creating downwards traction

Positive= 1 to 2 cm sulcus created between humeral head and acromion

Indicates multi directional instability of GH giant

Question 10

GH Apprenhension

Answer 10

GH JOINT INSTABILITY

Performed on patient with a history of subluxation or shoulder pain / no current pain

Patient supine on exam table examiner stands behind or at knob side, an externally rotate shoulder with the shoulder at 90° a deduction, an elbow at 90°
(Push their arm backwards in 90/90- they wont let you)

Positive= Shown apprehension, or reported pain by patient
Notes anterior instability

Question 11

NEER impingement test

Answer 11

SUBACROMIAL IMPINGEMENT

Perform on patients with history of pain, but none currently

Examiner raises patient’s arm deflection with internal rotation of the shoulder

Positive = reproduction of pain

Question 12

Hawkins Kennedy impingement test

Answer 12

Subacromial impingement
Performed on patients with history of pain, but not currently

examiner place is patient into 90° Shoulder flexion, 90° elbow flexion and places internal rotational force on forearm

Positive = reproduction of shoulder pain